Does combining ADT with radiotherapy (RT) always improve outcomes?

Combination of androgen deprivation therapy and radiotherapy for localized prostate cancer in the contemporary era. By D’Angelillo et al. 2014

 

Key sentence from the paper: “[T]he survival benefit given by the combination of RT plus ADT was confined to patients with no or minimal co–morbidity, while patients with moderate to severe co-morbidities had a nullified OS [=overall survival] benefit.””

 

For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/25459667

  

Commentary: This is a larger review article that summarizes 30 years of studies on the use of ADT to enhance RT; i.e. neoadjuvant ADT. The article challenges many studies in this area and comes to the conclusion that ADT may be of no benefit and even harmful in terms of overall survival for patients with substantial cardiovascular risks before they begin hormonal therapy. This is yet one more paper emphasizing the issue that prostate cancer patients have to be as concerned about their cardiovascular health as their cancer control.

  

D'Angelillo RM, Franco P, De Bari B, Fioretino A, Arcangeli S, Alongi F. 2014. Combination of androgen deprivation therapy and radiotherapy for localized prostate cancer in the contemporary era. Critical Reviews in Oncology/ Hematology 93(2):136-148.